What it changes
A dorsal hump is lowered; a low bridge is built up. The aim is a straight line that belongs to your face rather than one borrowed from someone else’s, which is why photographs of other people are a starting point for conversation and never a target.
The tip is refined or supported with fine sutures and, where structure is needed, your own cartilage. It is the most delicate part of the operation and the slowest to settle — the last of the tip swelling resolves over the second half of the first year.
A deviated septum or a collapsed valve is corrected in the same operation. Function is never traded for appearance: a nose that looks better and breathes worse is a failed rhinoplasty.
Open or closed
In a closed approach every incision is inside the nostrils and there is no external scar. In an open approach one small incision crosses the columella, the strip of skin between the nostrils, which lifts the skin and gives direct sight of the framework underneath.
Neither is better in itself — the nose decides. Revision work, a badly deviated framework, or a tip that needs substantial rebuilding usually argues for open. Either way, the work underneath is the same, and the columellar scar fades to a fine pale line.
How the operation is done
A general anaesthetic. One and a half to three hours, longer for a revision. The hump is lowered, the bones narrowed, the tip refined with sutures and your own cartilage where support is needed.
Dissolving stitches inside, and a splint on the bridge. You go home the same day or the next morning.
Recovery
What actually happens, week by week
Recovery is part of the treatment rather than an afterthought, so it is described here in the same detail as the operation.
Day 0–2
Splint and restA splint on the bridge. Sleep propped up. Blocked breathing is normal.
Day 3–7
Bruising peaksBruising around the eyes darkens, then fades from about day four.
Day 7–14
Splint offThe nose looks swollen and upturned at this stage — that is expected. Back to work.
Week 3–8
Normal to othersOthers stop noticing; you still will. Light exercise from four weeks.
Month 6
Almost finalThe shape is close to final. Tip swelling finishes over the second half of the year.
Honesty
Risks, and what can go wrong
Every operation has them. They are listed here because a patient who has read them and still wants to proceed is a patient who will be content afterwards.
- Prolonged swelling of the tip — the commonest cause of early disappointment, and the reason six months is the honest milestone rather than six weeks.
- Numbness of the tip for several months.
- A small irregularity of the bridge felt more easily than seen.
- Around one rhinoplasty in ten needs a small revision, most often for a minor contour issue; this is discussed before the first operation, not after.
Results
Photographs
Before-and-after photographs for this procedure are published on the main page as they are taken, under the same rules as every other case on this site: the same frame, the same distance, the same light, and no retouching beyond the masking that protects identity.
Nothing is published without the patient’s consent, and consent for one photograph is not treated as consent for all of them.
Take it away
The printed sheet
Everything on this page, on two sides of A4, written for patients and free to take from the clinic. It says what the operation does, what it costs you in time, and what it does not fix.
Rhinoplasty (nose surgery)
Patient information — PDF, 2 pages
Open the sheet →Questions
What patients ask
How long until my nose looks final?
About six months for the shape to be close to final, and a full year for the last of the tip swelling. Anyone promising a final result in weeks is describing the splint coming off, not the nose settling.
Will there be a visible scar?
In a closed rhinoplasty, no — every incision is inside the nostril. In an open rhinoplasty there is one small incision across the columella, which fades to a fine pale line and is not what people notice about a nose.
Can breathing problems be fixed at the same time?
Yes, and they should be. A deviated septum or a collapsed valve is corrected during the same operation. Function is never traded for appearance.
When can I wear glasses again?
Keep them off the bridge for at least four weeks — tape them to the forehead or use contact lenses. Pressure on healing bone can move it.
How long should I take off work?
Plan two clear weeks. The splint comes off between day six and ten, and the bruising has usually gone by two weeks. Avoid anything that will be photographed for a month.